West Denver Equitable Education Collaborative
First Name: Last Name:
Preferred Phone: Best time to reach you:
Do you have a child/children currently attending Denver Public Schools? YES NO
What school(s) do they attend?
How would you best describe yourself? (Mark all that apply.)
Parent Teacher Student Community Member DPS Alumnus
Agency Representative Parent of Special Needs Child
Former DPS Parent Future DPS Parent
Parent Forum Member at __________________________________ (school)
Other, please specify
Please describe your interest in serving on the West Denver Equitable Education Collaborative: (100 words max.)
Please affirm (by signing below) your interest in and ability to participate fully in this process; and that you are committed to contributing to improving and enhancing the educational opportunities for students in West Denver, and that you represent no organization that has a business, political or lobbying interest, or any other entity whose participation on this committee would present a conflict of interest with DPS.
__________________________________Signature (type name or sign)
To be chosen for the WDEEC, please return this form by 5:00 p.m. on Friday, February 11, 2011. Visit www.WestDenverEEC.org. Please return this form via email to firstname.lastname@example.org or by fax to 303-586-6292. Notification of committee members will be made by February 18, 2011. The first meeting will be held on February 23, 2011 at 5:30 pm, at Greenlee Elementary School, located at 1150 Lipan Street. Dinner, childcare and interpreters will be provided.